Psychotherapy for erectile dysfunction: now more relevant than ever.

Abstract

The introduction of sildenafil in 1998 dramatically altered the treatment landscape for erectile dysfunction (ED). Although physicians now have a simple, efficacious, and safe treatment for ED, psychosocial barriers interfere with patients making effective use of these interventions. The role of psychotherapy is clearer than ever before in optimizing therapeutic outcome. The four goals of psychotherapy for ED are to identify and work through the resistances to medical intervention that lead to premature discontinuation; to reduce or eliminate performance anxiety; to understand the context in which men make love; and to implement psychoeducation and modification of sexual scripts. This article discusses three factors that make psychotherapy effective as well as outcome studies evaluating psychotherapy. By providing patients with an integrated medical/psychologic treatment, clinicians are likely to increase significantly the effectiveness of their treatment interventions for ED.